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Confirmation of Intimal Tear in Thrombosed-Type Acute Aortic Dissection by Virtual Angioscopy.
T Cho1, S Tokunaga1, R Izubuchi1
1Department of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
EJVES Short Reports
|September 1, 2017
Summary
Virtual angioscopy aids in diagnosing acute aortic dissection by visualizing intimal tears, differentiating it from intramural hematoma (IMH) for better treatment planning.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
Background:
- Intramural hematoma (IMH) of the ascending aorta presents therapeutic challenges.
- Distinguishing IMH from acute aortic dissection is critical for patient management.
Purpose of the Study:
- To evaluate the utility of virtual angioscopy in differentiating ascending aortic intramural hematoma (IMH) from acute aortic dissection.
- To assess the role of virtual angioscopy in identifying intimal tears before surgical intervention.
Main Methods:
- A 72-year-old female patient presented with chest pain and suspected ascending aortic IMH on MDCT.
- Virtual angioscopy, based on MDCT data, was used to examine the aortic lumen.
- Diagnosis was revised to acute aortic dissection upon visualization of a punctate intimal tear.
Main Results:
- Multidetector computed tomography (MDCT) initially suggested IMH.
- Virtual angioscopy successfully identified a punctate intimal tear, confirming acute aortic dissection.
- Emergency surgery was performed with an uneventful postoperative recovery.
Conclusions:
- Virtual angioscopy offers a minimally invasive method to visualize the vascular lumen using MDCT-reconstructed images.
- This technique is valuable for detecting intimal tears in cases where MDCT is inconclusive.
- Virtual angioscopy effectively distinguishes acute aortic dissection from IMH, aiding therapeutic decisions.
